Tennis elbow: symptoms, causes and treatment

A tennis elbow or tennis elbow is often caused by one-sided or excessive strain. Pain on the outside of the elbow, which can radiate into the entire arm, is characteristic. How is tennis elbow treated and what exercises can be used to prevent it?

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Brief overview: tennis elbow

What is tennis elbow? It is a painful tendon irritation in the elbow. It is therefore also called tennis elbow.

symptoms: Typical is pressure pain on the outside of the elbow, which can radiate to the forearm and wrist. The affected arm is sometimes severely restricted in terms of mobility and function.

causes The culprit is usually a one-sided and/or excessive strain on the extensor muscles of the forearm.

Treatment Rest and immobilization of the affected arm are usually sufficient. Special tapes and bandages are used for this. Cold applications can be useful in the acute stage, while heat therapy is recommended for chronic symptoms. Other conservative treatment methods also include ultrasound or shock wave therapy.

forecast: For most sufferers, symptoms resolve within 12 months.

Article content at a glance:

Kinesio Tapes: Typical Applications

Kinesio Tapes: Typical Applications

What is tennis elbow?

Tennis elbow, also known as tennis elbow, is a painful irritation of tendons in the elbow. Specialists call it epicondylitis radialis humeri.

Tennis elbow or golfer’s elbow?

A similar clinical picture is the golfer’s arm (also golfer’s elbow, Latin: epicondylitis ulnaris humeri). In tennis elbow, the tendons attach to the extensor muscles

  • of the wrist and
  • the finger irritated,.

In golfer’s arm, the flexor muscles are irritated. There is usually pain on the inside of the elbow.

Contrary to what the name might suggest, both clinical pictures mostly occur in people who have never held a tennis or golf club in their hands. Other sports or physical activities that constantly overload the muscles can also cause the typical elbow pain.

Recognizing tennis elbow: symptoms and signs

Tennis elbow usually manifests itself as pressure pain on the outside of the elbow. The pain point is on the thumb side of the forearm, where the tendons of the forearm extensors attach to the elbow joint.

The pain starts in the elbow, but can radiate to the upper arm, hand and fingers.

Course of pain in tennis elbow

Initially, the symptoms only appear under stress or when performing certain movements and often disappear on their own a few hours or the next day. Later, the pain can also be felt at rest – many usual movements of the hands become torture.

Sometimes the hand becomes so weak that even holding a coffee cup becomes impossible and shaking hands is painful. In this condition, movement of the elbow joint is often restricted. However, this is not functional, but is due to the relieving posture of the affected arm.

The cause of tennis elbow is overuse and tendon irritation

The cause of the inflammation of the elbow is usually an overload or overuse of the muscles of the forearm. This is fused with all the tendons on a small bony process on the outside of the elbow. Constant repeated overload leads to inflammation of the periosteum, the appendage and the tendons.

Such movements can be, for example:

  • permanent firm gripping and holding of objects with the hand (tennis racket, but also brush, screwdriver, pruning shears)

  • Activities that require frequent flexing and stretching of the wrist (brush brushing, playing the violin, teeing off on golf, weight lifting)

  • Unfamiliar jobs not done often, such as lugging moving boxes, gardening, lifting and carrying heavy luggage

Other possible risk factors

Certain factors can increase the risk of the disease. This includes:

Other risk factors are older age and weak forearm muscles in the elbow area.

Tennis elbow: This is how the diagnosis is made

Tennis elbow is one of the most common orthopedic diagnoses. As a rule, the description of the symptoms and an examination of the arm are sufficient to make the diagnosis.

Various provocation tests support the diagnosis of tennis elbow or golfer’s elbow. To do this, those affected must, for example, stretch or bend their fist or outstretched hand against pressure up or down in the wrist. In the “chair test”, the person to be treated should hold the backrest of a chair with their arm outstretched and lift it. With a tennis or golfer’s elbow, the typical pain can be triggered with these resistance tests and the stretching.

For a differentiated diagnosis and the exclusion of other clinical pictures, X-rays, a CT or MRT examination and a laboratory test of the blood may also be necessary.

This is important to rule out medical conditions that cause similar symptoms. These include, for example:

  • degenerative joint changes such as arthrosis

  • Changes or blockages in the cervical spine

  • pinched nerves

  • inflammatory processes at the elbow joint

  • rarely tumors

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Groin strain: 15 tips to heal faster

Tennis elbow: treatment and prognosis

Although tennis elbow is painful, it usually heals well. Rest and immobilization are often enough to relieve the irritated tendon. Sporting activities and manual work should initially be stopped until the pain is free. Tapes (kinesio tapes) or a special bandage, the epicondylitis bandage, are often used for support today.

Other treatment methods include:

  • Cold treatments (in the acute stage)

  • Heat applications to stimulate blood circulation (in the chronic stage)

  • manual therapies (transverse friction)

  • special stretching exercises

  • Ultrasound (sonography)

  • hydroelectric baths

  • Pain medication (especially non-steroidal anti-inflammatory drugs)

Accompanying can in the acute phase acupuncture and extracorporeal shock wave therapy support the healing process and relieve pain.

Do injections for tennis elbow help?

Various injection treatments are available to treat tennis elbow. However, their effectiveness is controversial and often not sufficiently proven by studies. The following active ingredients are mostly used:

  • cortisone: Local injections of cortisone followed by immobilization used to be the drug of choice. However, since the steroid doses can structurally damage the tendon tissue, according to medical guidelines, they should not be repeated more than two to three times.

  • hyaluronic acid: The body’s own substance is found in tissues and joints. It is often used to treat arthrosis. Studies provide evidence that injections with hyaluronic acid can also provide relief for tennis elbow.

  • botulinum toxin: The nerve toxin Botox is injected into the extensor muscles of the forearm, causing immobility by paralyzing the muscles. Side effect: Possible paralysis of the fingers for several weeks.

Tennis elbow: Surgery as a last resort

If the symptoms persist, an operation may also be necessary in individual cases. The affected tendon attachment is separated from the elbow bone, and in individual cases nerves that transmit pain are also “shut down”. However, surgery should only be considered as a last resort when all other measures have failed.

Tennis elbow: what is the prognosis?

The prognosis is mostly favorable. In more than 90 percent of those affected, the symptoms resolve within twelve months. It is crucial to obtain expert advice at an early stage and not to delay therapy.

In more than 80 percent of cases, freedom from pain can be achieved with an operation.

How to prevent tennis elbow

Tennis elbow is common, but it can be prevented. It is important to avoid permanent incorrect and overloading. The following tips can help.

  • Anyone who has to work a lot with their hands can prevent irritation of the tendon in the elbow by choosing suitable (ergonomic) tools.

  • If there is major, unfamiliar work to be done at home when renovating, in the garden or cleaning the house, it is advisable not to overdo it. Especially when the arm muscles are untrained, you should take regular breaks.

  • Anyone new to a sport or learning an instrument should learn the most important basic techniques and the correct posture right from the start.

As a prophylactic, athletes can put on special bandages or tape bandages during training and competition phases. However, their effectiveness in professional sports is controversial. Tennis players should use a racquet cover with better cushioning if necessary.

Tennis elbow: exercises to do at home

Well-trained muscles protect against injuries and illnesses. In the case of tennis elbow, these are primarily the muscles and tendons of the forearms. This can be strengthened at home with a rubber ball, rubber ring or special hand trainers. This is particularly recommended for people who otherwise only have to grab lightly with their hands in everyday life. Regular stretching also ensures that the forearm tendons do not shorten and lead to pain.

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